Tag: cognitive behavioral therapy

19 Steps

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  1. Endure a number of episodes unnoticed
  2. Act out and destroy things/people
  3. Retreat
  4. Avoid everything
  5. Get confronted by family and friends
  6. Get hospitalised
  7. Self assess
  8. Decide you need to see a GP
  9. See a GP, get referred to psychologist
  10. See a psychologist, get referred to psychiatrist
  11. Argue with the psychiatrist, because they’re shit at their job
  12. Get a better psychiatrist who gets you
  13. Do the sessions/take the meds
  14. Eat/sleep/exercise/meditate
  15. Manage your self better, and learn the signs
  16. Build a safety net of family and friends
  17. Get continually better
  18. When an episode is coming, let people know
  19. Repeat

+++++

[shirt]

The Screw-you Genie

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I have this voice inside my head. No, okay, not a voice, not in the “hearing voices” kind of way. A personality? No, that’s MPD. It’s more like a splinter of personality?

Anyway, I like to think of it as a genie that lives in a lamp in my head. It’s quiet most of the time, but when I’m in a position where I am expected to comply – with anything – the expectation rubs the lamp and the genie comes out and starts jumping and yelling and throwing things.

“YOU WANT THIS GUY TO DO A THING I DON’T THINK SO BUDDY YOU AIN’T THE BOSS OF MY PAL FUCK YOUR EXPECTATIONS WE DO WHAT WE WANT WE AIN’T SIGNING SHIT”

I call it the “screw-you” genie, because the only wish it grants is the capacity to flip people the bird without giving a shit.

And, you know, I’ll sign the damn paper or whatever, because it needs doing, and I just tell the genie to shut up and get back in its box/lamp/whatever.

But when I’m too weak to control it – when I’m dead-tired or angsty or I’ve been drinking or I’m heading towards depression – it gets loose. And just like the trickster djinns of old, it starts causing trouble by granting wishes I didn’t even know I had. And all the noise usually makes in my cranium suddenly comes spilling out of my mouth.

And I’m finally beginning to realise that this stupid genie has been responsible for oh-so-many incidents where I’ve lost friends and gained nothing but regrets in return – where I’ve suddenly flipped out and said things or done things that are out of character.

At least, I’d like to think they are. Stupid genie. Stop granting wishes I don’t even want.

She will not call you back

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This is a note to remind my future self of two key facts:

  1. I have bipolar
  2. I am physiologically sensitive to stimulation (introverted)

I feel things that – while very real for me – may not be congruent with the environment. Furthermore, these feelings are excessively acute – my nervous system and brain literally feel things more keenly than your regular person might.

So, when I feel a sudden spike of energy, I am aware that it could be limerent emotions that are not necessarily reciprocated. Nonetheless, if they appear congruent and reciprocal, it is good to see where they lead. I should keep this in mind in future, as awesome things can and do happen.

If circumstances change, however, and the feeling seems to wane, it is important to check with the party in question to see if this is an artifact of either of the above conditions, or if this is something that is manifest in the world outside my head. And in both cases, it is vital to acknowledge the shift.

Should it become apparent that the shift is real, that something is missing and the feeling cannot be induced or revived, then it is best to step back and cogitate before making further decisions.

Give yourself the space and the time to make awesome decisions.

And again, communicating these actions is vital to healthy relationships. Simply acting on emotions alone means there is a good chance that the response is inappropriate, unwelcome, uncomfortable for all concerned.And I know this is hard, future self, because the feelings are so strong and to not act on them in the heat of the moment feels unnatural, painful, and it stresses you out.

Stop and think.

So, this is a note to my future self. The relationship is over. You both tried, but the chemistry of the interpersonal relationship was not right. There was no gel. From the intelligent, rational perspective, it looks like you’re both suited for a solid, awesome friendship that, given time, may reemerge, and you can both enjoy each others company once again.

Maybe.

Future self, this is important. Do not give in to the temptation to wreck that future out of a misplaced sense of betrayal. Do not even attempt contact. Now is the time for quiet. Now is the time for peace.

Be cool.

Besides, she will not call you back.

Third Thoughts

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You know the phrase “having second thoughts”? Well, turns out these changes of mind aren’t enough for people like us. We need to have a whole new way of thinking just to get on in the world.

We need to follow a special process – one that lets us break down our world in to manageable chunks, ruminate on them, and then examine these ruminations.

  • First Thoughts = this is your immediate response to input, stimulus or a change in cognition. Reactive and raw, automatic and unapologetically judgmental.
  • Second Thoughts = this is what you think about the input, and your response. This is where most people live. Cognizant of their own awareness, but unaware of their ability to shape it. Still just reacting to the world.
  • Third Thoughts = this is what you think about what you’re thinking. Is this response okay in context? Am I comfortable with this situation. It is the most helpful thing you can ever think, and unfortunately it is rare.

Part of cognitive behavioural therapy (CBT), mindfulness and a range of bipolar management strategies is the recognition of an episode before it begins.

For me, this involves taking a moment to examine not just what I’m thinking, but also why I’m thinking it and how that thought then impacts on everything else.

I stare into space a lot. But I’m working on it.

And if other people could just manage to try it once in a while, I have no doubt we’d be living in a nicer world.

Wood-chipper

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Loud. Fast. Impossible to argue against.

People open their mouths to get a word in and they get filled with unrelenting rhetoric.

You want sass? You want sarcasm or witty comments? Sure, you can have these things. Along with a rough diatribe of pulped metaphors flying at you too fast for comfort.

Seriously, there’s a reason woopdchippers have a hood over the business end. Its to keep the splintered spray away from the general public.

And anyone dumb enough to get in the way of an operating  woodchipper gets what they deserve – a stinging face and uncomfortable splinters.

Introvert

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“You’re a what?”
“I don’t believe you.”
“Not you. No way!”

But it’s true. I have a sensitive physiology that experiences stimulus at a heightened rate when compared to them normal people (whatever normal is).

So I often pick reading alone over partying. I choose writing with my headphones on over drinks with mates (sorry mates).Or a documentary or sketch session over beer-pong and battleshots. It has happened.

It’s just hard to believe. Because I’m also bipolar. And the high times? They give me the courage and confidence to be the kind of person who starts the party. To get excited and make things happen. Not always intelligent things, granted, but at the time it beats standing still.

The high times helped me work manically in high-pressure environments. Without the high times, I would have struggled way more than I did.

The high times have made it easy to say yes to knew experiences. To go to new places, experience new things.

Without the high times I would have stared at my shoes instead of smiling at the cutie in the cafe that one time.

But it comes at a cost, and that cost is exhaustion. I can’t always keep up with the high times. And I need to be okay with that.

It’s time to acknowledge my introvert tendencies for what they are. Not as a weakness or a handicap, but as a physical predisposition, same as being bipolar.

Anxiety Party

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It’s a three-day festival like mardi gras! Except instead of beers and beads and boobs there’s anxiety and headaches and frustration! And instead of floats there’s bouts of crippling doubt that make it hard to get out of bed or leave the house! And this metaphor has kind of gone off track, except that the time frame is still accurate! I can’t believe I’ve been like this for three days already!

WOOHOO

Self-Slaughter

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You don’t know me and I don’t know you. We may never meet. Or there’s a slight, slim chance—one in one hundred billion— that we’ve shared a class, a bus, a train, or even a glance on a street corner. Doesn’t matter.

You may have lots of pressing, urgent reasons to feel the way you do. Or a few really large ones. Or even huge volumes of large ones that feel like they’re crushing the life out of you. Doesn’t matter.

Because right here, right now, I am thinking of you.

Yes, as an abstract concept. Yes, as a projection of myself onto the idea of a person I don’t know and can never hope to understand as complexly as I’d like. And yes, in the hope that maybe you are capable of looking and listening to this point of view.

I am thinking of you kindly, without pity or reservation. And I am thinking this thing at you so hard:

Self-slaughter does not stop life from getting worse. It only ever stops life from having the chance to getting better.

Self-harm doesn’t improve life. Not for you, not for anyone. Everything in life is repairable, mutable, changeable. Everything can be overcome. Everything is manageable, given time. But self-slaughter removes that opportunity.

Doing harm to ones self feels like an escape, a way of exerting control. But self-destructive behaviour is not a way forward. It is, by definition, a step back.

It is a cage. And as I write this and think of you, dear reader, I hope you can see this for what it is – an opportunity to sit and think and take stock and just maybe consider things from this viewpoint.

Thank you for reading.

Infernal Combustion

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My dad used to say all cars ran on infernal combustion engines. A good pun, but there’s something there. The image of a solid core of black that roars and drips searing metal flame – an engine of hate captured and directed by fine engineering. A machine that puts dark energy to use.

That’s an image I cling to now. It’s not the worst feeling, the sensation of mindless animal rage tempered only by training, awareness and willpower. It’s good to feel. But it’s a feeling I fear nonetheless.

See, at this stage I could go either way:

  • The engine could still sputter out, bereft of the loathing of living that is its fuel before it does any real damage. When it stops, I can resume normality, possessing a mind clear free of the misanthropic fumes.
  • Or it could have fuel enough to bore a hole in my psyche into the vacuum of true depression, sucking emotion and motivation out into the darkness before it too is silenced.

I fear it because I have no control over it. Even with all the mindfulness exercises and CBT, I’m still barely in the driver’s seat. I’m just going through the motions and trying to keep things on track. Politeness isn’t always an option, but nobody’s getting hurt.

So maybe that’s enough.

Working Out

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Neuroplasticity is a wonderful thing. It means that thought patterns are changeable, and brain-parts are programmable.

It means that brain-training works. There’s a growing draft of research that literally shows the brain changing itself in response to new stimulus. Every thought and every action literally shapes your brain. Even the way you think about how you think can train your brain to change.

For me, the key to managing bipolar is knowing when a mental state-change is happening, and preparing to deal with it. Like an athlete training for a grueling event, you can train your brain to become resilient, flexible, tough.

Music, reading, eating, talking, listening, being physically active, thinking, and thinking about thinking are all part of my mental gym. Done right, you can build a brain that’s tough enough to withstand the bad times, and agile enough to think through rash decisions before a compulsion becomes an act.

But just like a gym session, it takes commitment. This isn’t something you can sign up to at the start of the year and quit after a month. This is for life.

Working out your brain is far tougher than any New Years resolution. Quitting smoking? Losing weight? Climbing Everest? Easy.

But it’s also ten- no a hundred- no FIVE MILLION TIMES as rewarding. Because you have a chance of building a mind that works the way you want it to, and you get to enjoy the benefits every single day, regardless of where you are.

You won’t get that kind of rewards program out of a gym membership, I don’t care how generous their terms are.

So get up! Read that CBT lit you got in the doctors office. Call the therapist you’ve been holding back from. Book a fresh round of appointments and be honest about the meds. Go for that walk in the greenery. Listen to music that makes you feel. And think. Think about what’s happening. Give yourself the time and permission to examine your environment, to study every piece of stimulus.

And then, think about what you’re thinking about! Notice the changes in mood for what they are, and decide if the stimulus is causing it or if it comes from within. Use neuroplasticity to make mental workouts an automatic habit. Build the strength you need in your head to live life on your terms.

Make it part of your brain.